Gave Blood transfusion too fast maybe? - page 3

Wanted to ask if anyone knew any effects of issuing a blood transfusion too fast besides the obvious ones that are easily found or included in text. What happened is my patients was admitted for a... Read More

  1. by   Mavrick
    Quote from /username
    I've given 10 units of blood in 15-20 minutes.

    You're fine.
    NO, you are NOT. (In the vast majority of cases)

    I would need a clinical condition that would support the decision to give 10 units of blood in 15 minutes.
  2. by   /username
    Quote from Mavrick
    NO, you are NOT. (In the vast majority of cases)

    I would need a clinical condition that would support the decision to give 10 units of blood in 15 minutes.
    How about a cracked chest at the bedside that's bleeding out?

    Or how about a massive trauma with a HGB of 2.5?

    Good enough for you?
  3. by   psu_213
    Quote from /username
    How about a cracked chest at the bedside that's bleeding out?

    Or how about a massive trauma with a HGB of 2.5?

    Good enough for you?
    Those are most definitely not in the "vast majority of cases." I think Maverick's point was (and I apologize for putting words in people's mouths) that even though it can be done, i.e, 10 units in 15 mintues, and you were OK doing it before, it does not always mean it is good idea; especially in this case, because we know very little about the clinical situation of the pt from the OP.
  4. by   /username
    Quote from psu_213
    Those are most definitely not in the "vast majority of cases." I think Maverick's point was (and I apologize for putting words in people's mouths) that even though it can be done, i.e, 10 units in 15 mintues, and you were OK doing it before, it does not always mean it is good idea; especially in this case, because we know very little about the clinical situation of the pt from the OP.
    My point is that when proper safety protocols are followed, there presents little to no risk for the patient. Most transfusion guidelines are extremely conservative, and the OP is worried that one unit over 4 hours is too fast which is laughably absurd.
  5. by   brownbook
    Quote from /username
    My point is that when proper safety protocols are followed, there presents little to no risk for the patient. Most transfusion guidelines are extremely conservative, and the OP is worried that one unit over 4 hours is too fast which is laughably absurd.
    One nurse giving 10 units of blood in 15 minutes.... I envision the I Love Lucy episode where a conveyor belt has candy and she has to wrap each piece. It goes faster and faster, she ends up stuffing unwrapped candy in her mouth, down the front of her dress, etc.

    I don't think it's physically possible! That's more absurd to me than a new nurse concerned about fluid overload and her patient's hgb not going up enough.
  6. by   /username
    Quote from brownbook
    One nurse giving 10 units of blood in 15 minutes.... I envision the I Love Lucy episode where a conveyor belt has candy and she has to wrap each piece. It goes faster and faster, she ends up stuffing unwrapped candy in her mouth, down the front of her dress, etc.

    I don't think it's physically possible! That's more absurd to me than a new nurse concerned about fluid overload and her patient's hgb not going up enough.
    definitely possible.. level 1 and a cordis.
  7. by   brownbook
    Quote from /username
    definitely possible.. level 1 and a cordis.
    Okay, thanks for the info.
  8. by   Rose_Queen
    Quote from brownbook
    One nurse giving 10 units of blood in 15 minutes.... I envision the I Love Lucy episode where a conveyor belt has candy and she has to wrap each piece. It goes faster and faster, she ends up stuffing unwrapped candy in her mouth, down the front of her dress, etc.

    I don't think it's physically possible! That's more absurd to me than a new nurse concerned about fluid overload and her patient's hgb not going up enough.
    Aren't you in periop? You've truly never seen a massive transfusion for a trauma patient or major GI bleed? Not only is it possible, it can even be extremely organized. We use type and crossed if possible, type specific is the next step, and O neg if necessary (and for many of these it is). We have a response team that goes to the patient: an aide for transport between blood bank and patient location, one coordinator who assists with checking blood, tracking how much has been given, when to draw labs, and a few other duties. We then also have a transfusionist who runs the rapid infuser and checks blood with the coordinator.
  9. by   brownbook
    Quote from Rose_Queen
    Aren't you in periop? You've truly never seen a massive transfusion for a trauma patient or major GI bleed? Not only is it possible, it can even be extremely organized. We use type and crossed if possible, type specific is the next step, and O neg if necessary (and for many of these it is). We have a response team that goes to the patient: an aide for transport between blood bank and patient location, one coordinator who assists with checking blood, tracking how much has been given, when to draw labs, and a few other duties. We then also have a transfusionist who runs the rapid infuser and checks blood with the coordinator.
    Yeah, I know, I know, just the way username posted it..."I've given 10 units of blood in 15 - 20 minutes". Makes more sense to describe how you posted it. Not "one" nurse doing it, but a very large group of health care providers.
  10. by   Mavrick
    Quote from /username
    My point is that when proper safety protocols are followed, there presents little to no risk for the patient. Most transfusion guidelines are extremely conservative, and the OP is worried that one unit over 4 hours is too fast which is laughably absurd.
    In these RARE cases, the greater risk to the patient is their current condition. WITHOUT blood they are essentially dead.

    Do NOT confuse this with your much more common bedside blood transfusion. Proper protocols should always be followed to minimize the totally preventable risk of administering the wrong blood or the mostly preventable risk of administering it too fast for THAT patient.

    There may also be some confusion about the 4 hours to administer blood. The 4 hours refers to the suggested maximum time for blood to be out of the controlled temperature of the blood bank refrigerator. That includes transport, bedside checks, setting up the administration set or pump and then the actual administration of the blood. The idea is to minimize bacterial growth in the perfect media for bacterial growth. Don't want too many germs hitch-hiking a ride along with your blood transfusion.

    Forcing blood to hang over 4 hours (90ml/hr) is unnecessarily slow and worth a chuckle.
  11. by   Mavrick
    Quote from brownbook
    Yeah, I know, I know, just the way username posted it..."I've given 10 units of blood in 15 - 20 minutes". Makes more sense to describe how you posted it. Not "one" nurse doing it, but a very large group of health care providers.
    Interesting factoid: A single hemodialysis nurse can give multiple units of blood pretty dang fast.

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